ICD-10 B97.21
Billable / Specific CCSARS-associated coronavirus as the cause of diseases classified elsewhere
About ICD-10-CM B97.21
ICD-10-CM code B97.21 represents SARS-associated coronavirus as the cause of diseases classified elsewhere. This is a billable/specific code in the Infectious and Parasitic Diseases chapter (block B97). The 2026 edition of ICD-10-CM B97.21 became effective on October 1, 2025.
Coding Tips for B97.21
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
B97.21 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
Type 1 Excludes
Pure excludes, these codes can never be coded together with B97.21. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- pneumonia due to SARS-associated coronavirus (J12.81)
Inpatient DRG Impact, CC
codes SARS-associated coronavirus as the cause of diseases classified elsewhere. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for B97.21
Local Coverage Determinations (LCDs) from CMS MACs that list B97.21 as a covered diagnosis.
Showing top 10 of 540 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing B97.21.
5 Medicare
CPT Codes Commonly Billed with B97.21
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Convert B97.21 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| B97.21 | 07982 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To B97.21
Other codes in section B95-B97 (Bacterial and viral infectious agents).
ICD-10 B97.21, Billing FAQ
Is ICD-10 code B97.21 billable? +
Yes, B97.21 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What codes are Type 1 Excludes for B97.21? +
Type 1 Excludes (never code together with B97.21): pneumonia due to SARS-associated coronavirus (J12.81)
Is B97.21 a CC or MCC for inpatient DRG? +
Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What ICD-9 codes does B97.21 map to? +
Per CMS GEMs, B97.21 maps to ICD-9 codes: 07982. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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